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Case presentation to demonstrate how Turk Talk works.

You are called to see Chester Minnit, a 45yo man, with chest pain. You are in the Emergency Room.

When you go to see Chester, he is sitting up in bed, clutching his chest and looking worried. He has had chest pain for 45 minutes and describes the chest pain as like a toothache, but sharp at times. The chest pain is central and does not radiate anywhere. He is not short of breath and has had no chest trauma. He does not get chest pain with exertion.

He has been otherwise well and has no significant past history of ischemic heart disease, diabetes or hypercholesterolemia. He has no family history of these either.

On examination, he is not pale or sweaty. He is not using accessory muscles for breathing. His peripheral perfusion is good. When you palpate his chest, you note that his apex beat is normal in character and position. You also note that he seems diffusely tender across his precordium. Springing his ribs causes mild discomfort but is not well localized.

When you auscultate his chest, you find that his heart sounds are normal with no sign of a pericardial rub. However, he does have quite a thick chest wall so you cannot be sure about this. His lungs sound clear, with normal air flow. You do not hear a pleural rub. Percussion of his chest elicits no dullness - but remember that thick chest wall, so again, hard to be sure.